Dr Debbie Hayton interview

[ChristinaXYZ]

In case you haven't seen it.

“I worry that trans people are being used in a political campaign to compromise women’s spaces”

is the NASUWT guidance a safeguarding issue?

I'm increasingly minded that it is. It needs to be challenged and any influence during their creation scrutinised for whether the evidence behind it is robust rather than indicative of unevidenced partiality and emotional manipulation.

It's very strange how much pushback women get here for asking questions.

I know that I hold a view that other's disagree with regarding men wearing skirts at work or in general life. I think it needs to be normalised such that there is no AGP thrill to be had simply by wearing standard clothing.

I can hold and defend that view despite other women (who I massively respect and hate disagreeing with) thinking I am wrong and expressing so forcefully.

That's how I understand forums like this to work.

Fwiw I don't consider myself particularly angry or ranting. I just want us to centre women in women's issues.

And I am not expecting a reply about the NASUWT guidelines anytime soon, as R0 has shown, this has been raised by women multiple times and studiously ignored.

@Justhadathought

Perhaps Debbie has been able to individuate (in the Jungian integration of the conscious and unconscious self sense) and Robin is at an earlier stage on her journey towards wholeness and self awareness. Perhaps with hindsight it would have been possible without transition, but from the description of dysphoria it sound like it is rather all consuming and not conducive to psychological integration

Yes, i think we all have the tendency to first project ourselves and our issues onto the material world, and try to live them or resolve them that way. Of course, this never works for long because the struggle is an internal one, and it is only on this level that it can can really be resolved.

Wishful thinking, I would respectfully suggest.

Debbie embarked on a journey and has found the destination unsatisfactory. Debbie will have to decide whether to stay where she is or retrace the path.

I, on the other hand, like the overwhelming majority of trans folk I know, am happy with where I am now after transition and am no longer on any form of journey.

It is plainly a tragedy for those who embark on the journey only to find it was wrong for them and those around them and I am wholly supportive of efforts to minimise that risk. However, I also recognise that this journey is right for a good number of folk and it is an equal personal tragedy to bar that way for all.

If we are a society based on free will then folk are going to make wrong choices from time to time.

Should adults be able to modify their bodies in order to feel more comfortable with them?

Thankfully, we are not in a society where adults have completely free rein to modify their body . There is a Safeguarding framework including, in extremis, where there is significant 'risk of harm to self' being detained (also known as sectioned) under the Mental Health Act for assessment or treatment.

It is rather disingenuous to frame the question as being whether adults have the right to modify their bodies since in the context of UK, the desired cosmetic surgeries and side effects of long term hormone medications are mostly demanded of the NHS.

I would hope that no-one is advocating a system whereby surgeons (including those specialised in private cosmetic work) practise unconstrained by medical ethics and Safeguarding principles?

Guardian 2000
'Healthy limbs cut off at patients' request
NHS trust puts stop to surgeon's amputations done as last resort on disturbed patients with 'life threatening' hate of their own bodies'
(extract)
"A surgeon who amputated the healthy limbs from two psychologically disturbed men at their request said yesterday that he saw nothing wrong with his actions and that he was disappointed he would not be able to carry out such operations again.

Robert Smith cut off the lower legs of two patients, one from England and one from Germany, during private operations at Falkirk and district royal infirmary. The men had been turned away by surgeons across Europe before Mr Smith agreed to operate.

Mr Smith said, however, that he did not want to specialise in the procedure. "The last thing I want to be is a world centre for cutting off arms and legs."

Advertisement
The two men were suffering from an extremely rare form of body dysmorphic disorder known as apotemnophilia. Those suffering from the disease have an obsessive belief that their body is "incomplete" with four limbs and will only be complete after amputation. In most cases of apotemnophilia the desire to be an amputee is linked to a form of sexual arousal, but Mr Smith said there was no suggestion that any of his patients were motivated by sexual urges.

Following an internal investigation, Forth Valley NHS trust has now effectively banned Mr Smith from carrying out further procedures on people suffering from the disorder. Private hospitals have also refused to allow Mr Smith to carry out the procedure.

Mr Smith said he had six more patients waiting to be considered for amputation, two of whom had been fully assessed by psychiatrists as suitable candidates. The disorder takes over patients' lives and Mr Smith said that one of his patients had already tried to persuade friends to shoot off one of her limbs.

"My fear is that someone will injure or kill themselves," he said. "I have very serious concerns that they will go to an unlicensed practitioner or take the law into their own hands and lie down on a railway line, or take a shotgun."

Mr Smith's patients, whom he said were severely disabled by their disorder, had rigorous psychological and psychiatric evaluations before their operations. His decision to carry out the amputations was legal.

Kenyon Mason, a professor dealing with medical ethics, said the law would view the case in much the same way as it would gender reassignment. "As long as you say that people can have a sex change for what is a severe psychological disease, then it is difficult to say you cannot have an amputation for this form of severe psychological disease," said Professor Mason." (continues)
www.theguardian.com/society/2000/feb/01/futureofthenhs.health

Mr Smith said he had six more patients waiting to be considered for amputation, two of whom had been fully assessed by psychiatrists as suitable candidates.

Dr Russell Reid (regarded at the time as being the UK's best-known expert on transsexualism) provided that assessment and was interviewed for BBC Horizon:

'Complete Obsession'
BBC2 Thursday 17th February 2000
( transcript extract)

NARRATOR: Robert Smith will only consider operating on a patient after they have been seen by at least two psychiatrists who confirm that they are sane and are body dysmorphic. One of the few psychiatrists who has seen such patients is Russell Reid. An experienced consultant psychiatrist, Dr. Reid usually specialises in treating transsexuals.

DR. RUSSELL REID (Consultant Psychiatrist): Certainly when I first heard of people wanting amputations it seemed bizarre in the extreme but then I thought well, I see transsexuals and transsexuals want healthy parts of their body removed in order to adjust to their idealised body image and so I think that was the connection for me. I saw that people wanted to have their limbs off with equally as much degree of obsession and need and urgency and it was a powerful emotion.

I think in that sense it's a psychological obsession. These people are not mentally ill in the sense of having a serious mental illness or psychosis. They're not hearing voices, they're not deluded. It's not as if some force is telling them to have their limb off and they're following their paranoid delusion to do that. If that were the case then they would be psychotic, but they're not like that.

CORINNE: I haven't lost touch with reality. I know I have legs, but I also simultaneously imagine and sort of live my life mentally as an amputee. I did start renting a wheelchair for weekends around the home to get a sense of how, how my daily life really would change. There are things that I won't be able to reach and I'll have to sort of rearrange my home, but the overwhelming emotion when I first settled into the chair the very first time was just, it was like coming home." (continues)
www.bbc.co.uk/science/horizon/1999/obsession_script.shtml

NB In 2007 Russell Reid was disciplined for unsafe practise:
Guardian
(extract)
"The disciplinary panel ruled that Dr Reid must no longer prescribe patients with sex-changing hormones at the first appointment, nor without a firm diagnosis that they are transsexual or a proper psychiatric assessment.

The panel determined that the consultant psychiatrist was too quick to provide patients with hormones and to refer them for genital surgery.

"The panel considers that the seriousness of your misconduct lies in your lack of caution in initiating hormonal and surgical gender reassignment treatment in these patients without more careful and through investigation and assessment," said John Shaw, the panel chairman.

"The panel therefore determined that your misconduct was serious, and that you are guilty of serious professional misconduct."
www.theguardian.com/society/2007/may/25/health.medicineandhealth2

If we are a society based on free will then folk are going to make wrong choices from time to time.

In addition to what R0wan wrote re limits on medical procedures for ethical reasons, we don't live in a society based merely on 'free will'... and leaving aside that apparent 'free will' doesn't exist in a vacuum inside our heads...our 'choices' are all a complex product of nature, nurture and circumstance...I'm not philosophically convinced by 'free will', it may be illusory, but that's a whole other thread or ten!....

1. good parents exercise loving constraints on their children's free will. You hold your children's hands until they have the capacity to cross the road safely - and they understand what's on the other side of the road.

2. our 'free will' is constrained by the needs of others. Well, of course you can choose to infringe other's rights, but we live in a society where those rights matter and are subject to the rule of law.

[quote R0wantrees]Should adults be able to modify their bodies in order to feel more comfortable with them?

Thankfully, we are not in a society where adults have completely free rein to modify their body . There is a Safeguarding framework including, in extremis, where there is significant 'risk of harm to self' being detained (also known as sectioned) under the Mental Health Act for assessment or treatment.

It is rather disingenuous to frame the question as being whether adults have the right to modify their bodies since in the context of UK, the desired cosmetic surgeries and side effects of long term hormone medications are mostly demanded of the NHS.

I would hope that no-one is advocating a system whereby surgeons (including those specialised in private cosmetic work) practise unconstrained by medical ethics and Safeguarding principles?

Guardian 2000
'Healthy limbs cut off at patients' request
NHS trust puts stop to surgeon's amputations done as last resort on disturbed patients with 'life threatening' hate of their own bodies'
(extract)
"A surgeon who amputated the healthy limbs from two psychologically disturbed men at their request said yesterday that he saw nothing wrong with his actions and that he was disappointed he would not be able to carry out such operations again.

Robert Smith cut off the lower legs of two patients, one from England and one from Germany, during private operations at Falkirk and district royal infirmary. The men had been turned away by surgeons across Europe before Mr Smith agreed to operate.

Mr Smith said, however, that he did not want to specialise in the procedure. "The last thing I want to be is a world centre for cutting off arms and legs."

Advertisement
The two men were suffering from an extremely rare form of body dysmorphic disorder known as apotemnophilia. Those suffering from the disease have an obsessive belief that their body is "incomplete" with four limbs and will only be complete after amputation. In most cases of apotemnophilia the desire to be an amputee is linked to a form of sexual arousal, but Mr Smith said there was no suggestion that any of his patients were motivated by sexual urges.

Following an internal investigation, Forth Valley NHS trust has now effectively banned Mr Smith from carrying out further procedures on people suffering from the disorder. Private hospitals have also refused to allow Mr Smith to carry out the procedure.

Mr Smith said he had six more patients waiting to be considered for amputation, two of whom had been fully assessed by psychiatrists as suitable candidates. The disorder takes over patients' lives and Mr Smith said that one of his patients had already tried to persuade friends to shoot off one of her limbs.

"My fear is that someone will injure or kill themselves," he said. "I have very serious concerns that they will go to an unlicensed practitioner or take the law into their own hands and lie down on a railway line, or take a shotgun."

Mr Smith's patients, whom he said were severely disabled by their disorder, had rigorous psychological and psychiatric evaluations before their operations. His decision to carry out the amputations was legal.

Kenyon Mason, a professor dealing with medical ethics, said the law would view the case in much the same way as it would gender reassignment. "As long as you say that people can have a sex change for what is a severe psychological disease, then it is difficult to say you cannot have an amputation for this form of severe psychological disease," said Professor Mason." (continues)
www.theguardian.com/society/2000/feb/01/futureofthenhs.health[/quote]
Arguments at the extremes are easy. That Professor Mason’s view is not supported by the medical profession is clear by the actions of the Trust in Mr Smith’s case.

At the other extreme, few would argue that ear-piercing is wrong but it offends some beliefs.

Given that my gender confirmation surgery has allowed me to live in comfort and relieved the distress of gender dysphoria, in personal terms it was clearly the right thing to do. But there should clearly be, in my view, appropriate ‘gate keeping’.

The devil is always in the detail.

At the other extreme, few would argue that ear-piercing is wrong but it offends some beliefs.

There are well established safeguards in respect of piercings (as with tattooing) which have nothing to do with black and white beliefs of wrong/right but are rightly focussed on reducing risks and ensuring safe practise.

People live in a society so it's not totally true that what they do to their body only affects them. So, for example, boob jobs often need corrective surgery down the line, on the NHS. Presumably amputees have health care needs too.

This idea that we only look at actions in isolation is, in itself, a breach of safeguarding of everyone affected I think particularly when it comes to schools.

The NASUWT guidance suggests children should be forced to address a teacher according to their desires rather than reality or what the children themselves believe. So is it ok if a teacher changes their name by deedpoll to Mx MassiveCock? Would that be considered ok? Would children be forced to use this name?

What on earth did R0 post that got reported? And deleted? I read those posts and they made me think. Is thinking "not in the spirit" these days?

I was actually thinking what are the limits of personal autonomy, body modification within a free society.

Many cosmetic processes are linked to unhappiness and people have long queried if the body or mind should be changed in those situations.

The NASUWT guidance suggests children should be forced to address a teacher according to their desires rather than reality or what the children themselves believe. So is it ok if a teacher changes their name by deedpoll to Mx MassiveCock? Would that be considered ok? Would children be forced to use this name?

Teachers are bound by standards in UK:

"PART TWO: PERSONAL AND PROFESSIONAL CONDUCT
A teacher is expected to demonstrate consistently high standards of
personal and professional conduct. The following statements define the behaviour and attitudes which set the required standard for conduct throughout a teacher’s career.
 Teachers uphold public trust in the profession and maintain high
standards of ethics and behaviour, within and outside school, by:
o treating pupils with dignity, building relationships rooted in mutual
respect, and at all times observing proper boundaries appropriate
to a teacher’s professional position
o having regard for the need to safeguard pupils’ well-being, in
accordance with statutory provisions
o showing tolerance of and respect for the rights of others
o not undermining fundamental British values, including democracy,
the rule of law, individual liberty and mutual respect, and tolerance
of those with different faiths and beliefs
o ensuring that personal beliefs are not expressed in ways which
exploit pupils’ vulnerability or might lead them to break the law.
 Teachers must have proper and professional regard for the ethos,
policies and practices of the school in which they teach, and maintain
high standards in their own attendance and punctuality.
 Teachers must have an understanding of, and always act within, the
statutory frameworks which set out their professional duties and
responsibilities."

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/665522/Teachers_standard_information.pdf

What on earth did R0 post that got reported? And deleted? I read those posts and they made me think. Is thinking "not in the spirit" these days?

I was actually thinking what are the limits of personal autonomy, body modification within a free society.

I have requested clarity from MN mods.

I was actually thinking what are the limits of personal autonomy, body modification within a free society.

The BBC Horizon programme, " I have been referring to and also Malcolm Smith's perspective as a film maker involved are important sources of evidence in such a discussion.

transcript: www.bbc.co.uk/science/horizon/1999/obsession_script.shtml
documentary 'Complete Obsession - Body Dysmorphia' ok.ru/video/281953962725

Malcolm Smith
(extract)
"Later I was asked to help out on a BBC Horizon, (I'd directed a number of shows for the strand) on a film about people who believed they were 'meant' to be amputees. I interviewed an otherwise seemingly normal German guy who wanted both his legs cut off below the knee..
5/ A Scottish surgeon did the op. The psychiatrists who approved it were all schooled in trans ideas and used trans type arguments. 'He would commit suicide if we don't do it', they said. They also claimed they carefully distinguished people like him from 'mere' fetishists
6/ But it was quite clearly easy to fool the psychiatrists. If they needed fooling that is. I spent a lot of time with the German guy and a strange tale of an ...unusual.. upbringing emerged.
7/ His parents had, for example, owned a factory producing 'prosthetic limbs' and he complained 'they'd never had time for me...only for their patients'." (continues)
threadreaderapp.com/thread/1155458088964636675.html

I remember reading about those amputations at the time, and thinking that it kind of made sense if it was to stop the person self-harming in a dangerous uncontrolled way.

Then I looked again at "sex-change" operations, and they made more sense within that framework.

I then changed my thinking again years later after hearing the amputation operations had been stopped as unethical pretty quickly.

There are obvious parallels between the two situations. It definitely needs careful consideration if one is thought to be okay and the other not.

newyearnewname123 This was the point made by Dr Russell Reid in the programme.

(transcript extract)
"NARRATOR: Robert Smith will only consider operating on a patient after they have been seen by at least two psychiatrists who confirm that they are sane and are body dysmorphic. One of the few psychiatrists who has seen such patients is Russell Reid. An experienced consultant psychiatrist, Dr. Reid usually specialises in treating transsexuals.

DR. RUSSELL REID (Consultant Psychiatrist): Certainly when I first heard of people wanting amputations it seemed bizarre in the extreme but then I thought well, I see transsexuals and transsexuals want healthy parts of their body removed in order to adjust to their idealised body image and so I think that was the connection for me. I saw that people wanted to have their limbs off with equally as much degree of obsession and need and urgency and it was a powerful emotion.

I think in that sense it's a psychological obsession. These people are not mentally ill in the sense of having a serious mental illness or psychosis. They're not hearing voices, they're not deluded. It's not as if some force is telling them to have their limb off and they're following their paranoid delusion to do that. If that were the case then they would be psychotic, but they're not like that." (continues)

Important context is that seven years later Reid was found guilty by GMC of malpractice (within his 'Gender' clinics)

(extract)
"The disciplinary panel ruled that Dr Reid must no longer prescribe patients with sex-changing hormones at the first appointment, nor without a firm diagnosis that they are transsexual or a proper psychiatric assessment.

The panel determined that the consultant psychiatrist was too quick to provide patients with hormones and to refer them for genital surgery.

"The panel considers that the seriousness of your misconduct lies in your lack of caution in initiating hormonal and surgical gender reassignment treatment in these patients without more careful and through investigation and assessment," said John Shaw, the panel chairman.

"The panel therefore determined that your misconduct was serious, and that you are guilty of serious professional misconduct."

Mr Shaw said Patient D, who mistakenly believed she was transsexual as a result of suffering from manic depression, only narrowly avoid an "unnecessary mastectomy" as a result of Dr Reid ignoring the second opinion of another psychiatrist that treatment should proceed with caution.

The panel chairman added that Patient C, a convicted paedophile, was still uncertain about his gender identity after having a sex change. The male-to-female transsexual has returned to living as a man and wants surgery to try to reverse his gender reassignment." (continues)
www.theguardian.com/society/2007/may/25/health.medicineandhealth2

Thanks for that link to teachers' professional standards R0.

I think the NASUWT guidelines breach many points of that guidance.

If children in a teacher who is trans' class believe in sex-based pronouns (which I'd also argue is consistent with 'British values' as outlined - and the majority of the population still use sex based pronouns), the NASUWT guidelines says that their belief should not be respected, their well-being should not be considered, but that they should be forced to lie. Basically.

I think the NASUWT guidelines breach many points of that guidance.

I agree.

So why is one group allowed to breach those guidelines when all others have to adhere to it?

Lang used to say we should be very wary of creating a group of people to whom normal safeguarding rules do not apply.

As far as I can see, that is what the NASUWT trans guidelines do - it is a safeguarding failure.

It's also a failure of those trans people who genuinely do want to just live their lives in peace and without discrimination (without infringing the rights of women and children). Because allowing a particular group to bypass safeguarding will have predictable consequences which will not benefit trans people.

It's also a failure of those trans people who genuinely do want to just live their lives in peace and without discrimination (without infringing the rights of women and children). Because allowing a particular group to bypass safeguarding will have predictable consequences which will not benefit trans people.

And I would very much hope that all reasonable trans people would see that and want to rectify it.

The link between people who want to be amputees and those who are transgender is even stronger when you consider people like Chloe Jennings-White (who used to be known as Clive).

Jennings-White, a scientist in Utah, lives as a paraplegic, pretending to be paralysed from the waist down. She wears leg braces and uses wheelchairs and crutches. The problem, for those of us who struggle to indulge people – sorry, celebrate diversity – quite to this extreme, is that there is nothing physically wrong with Jennings-White. She lives a double life. When she’s out in the countryside, she happily gets out of her wheelchair and goes hiking. It is only in the company of others that she feels compelled to be seen as disabled.

Furthermore, she claims to want surgery to transect her spinal cord, so that she can really be a paraplegic. She calls it “Ability Reassignment Surgery”. Jennings-White, all in all, can best be described as the gift that keeps on giving. Often people who say they have BIID are transsexual or transgender men; Chloe, it has emerged, was apparently once Clive.

www.thetimes.co.uk/article/spinal-column-no-truck-with-transableists-r3qrr3glx73

Archive link:
archive.is/QI3SL

Lang used to say we should be very wary of creating a group of people to whom normal safeguarding rules do not apply.

LangCleg wrote Thu 21-Feb-19

"How did the scandal of TV entertainers grooming and exploiting children get so bad before anything was done?

How did the scandal of Catholic priests grooming and exploiting children get so bad before anything was done?

How did the scandal of on-street gangs grooming and exploiting children get so bad before anything was done?

Because if you create a sacred caste of any group and silence anyone asking questions about individuals on behalf of the sacred caste, abusers will see, infiltrate, and groom and exploit children. That''s how."

www.mumsnet.com/Talk/womens_rights/3512177-Julia-Long-asking-Munro-Bergdorf-about-child-exploitation?pg=12

People must always be wary of elevating any group of individuals beyond usual expectations and standards of scrutiny. In all situations and groups there is the potential for exploitation of status.

@EmpressWitchDoesntBurn

It's also a failure of those trans people who genuinely do want to just live their lives in peace and without discrimination (without infringing the rights of women and children). Because allowing a particular group to bypass safeguarding will have predictable consequences which will not benefit trans people.

And I would very much hope that all reasonable trans people would see that and want to rectify it.

And mixing up trans and safeguarding is just the same non-sequitur that we heard 20 years ago when homophobes told us that being gay and teaching were incompatible.

Well Robin explain to me why the NASUWT breaches the personal and professional rules of conduct for teachers that r0 linked to?

Why should children be coerced into lying in schools if a teacher who is trans demands it when no other teacher is able to require this?

Surely, you don't want children to be unsafe in schools and would like the NASUWT guidelines retracted so it is clear there is no such 'sacred caste' treatment going on?